Medical Progress and Creative Destruction

“Creative destruction”, a sometimes throwaway phrase with deep implications, occurs when creativity in all its forms (novelty, invention, or imagination) lays waste to established forms of culture, belief,  politics, business (manufacturing and distribution,) even behavior. The results can be as profound as revolutionizing, annihilating or causing replacement of whatever existed before. Examples abound throughout history.  Consider: the railroad and the automobile vs. horse and carriage, radio vs. the telegraph, email vs. the post office, social networks and the Internet vs. the publishing industry, the smart phone vs. the recording business, photography, even TV. At times, the obverse, “destructive creation” can be inferred as a kind of feedback loop.  The crossover point is somewhere between progress and failure.

Examples of destructive creation come to mind, such as software upgrades killing off perfectly good software to force consumers and industry alike into upgrading.  Consider the cost we endure for the replacement rate resulting from new products.. By discarding our household goods, cars, old TV’s, computers, and mobile phones, we “destructively” increase toxic and other waste. “Progress” thus results inevitably in environmental degradation.

Destructive Creation and Medicine

Medical Progress in the form of immunization, antibiotics, cardiac surgery, revolutionary imaging, etc. has been a colossal success story over the past century, conferring on our age extravagant improvement in health and longevity. Yet from time to time, we suffer disillusion when we learn, often long after the fact, that some promising new drugs are so dangerous they’ve been taken off the market, that uncountable cardiac procedures, such as catheterization, stent placement, implantable pacemakers were not indicated, that tens of thousands of joint replacement need never have been performed.

Dr. Eric Topol, in his 2011 book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care”, rhapsodizes over our smart phone detecting cancer cells, monitoring your brain waves, or warning you of an imminent heart attack. Could this be overshooting the runway? At the same time Topol was on the money when he predicted our vital signs could be monitored continuously, perhaps even our blood chemistries. After all, we now have the soaring stock price of the new IPO, Fitbit, “which tracks every part of your day—including activity, exercise, food, weight and sleep—to help you find your fit, stay motivated, and see how small steps make a big impact.

Does this mean we can now commodify the medical profession, as well as healthcare itself, by simply replacing them with digital technology and mobile devices?

 

Martin F. Sturman, MD, FACP

copyright 2015, Mathemedics, Inc.

 

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2 Responses to “Medical Progress and Creative Destruction”

  1. J. Otto Vrijhof says:

    “In order to make a medical appointment with some specialists at Pennsylvania Hospital in Philadelphia you must activate your account at their website in order to be provided with “secure, confidential, and convenient access to your personal medical record.”
    Does this stacked ‘in order to’ mean you have to have access to your personal medical record to make an appointment? Or does it mean that if you do not activate that access will not be secure?
    Their website says: “A representative from the contact center will contact you within 1 business day to help you schedule an appointment. For faster assistance, please call 800-789-PENN (7366).” Is this just a gentle introduction to their harsh demand later?

    Creative destruction, then, occurs when invention or imagination lays waste to established forms of manufacturing and distribution, revolutionizing, annihilating or causing replacement of whatever existed before.

    Does the ‘annihilating’ refer to ‘replacement of whatever existed before’, if so, why is there ‘or’ instead of ‘and’? Would ‘or’ not make it mean that the annihilation might not be followed by ‘replacement’ and therefore, indistinguishable from ‘destruction’ per se? And if not why is there not a comma after ‘annihilating’?

    >conferring on our age extravagant improvement in health and longevity.
    “extravagant” Indeed! We should return to the Age of Modesty; too much of a good thing can make you sick paradoxically. (Rosalind: Are you not good? Orlando: I hope so. Rosalind: Why then, can one desire too much of a good thing? As You Like It Act 4, scene 1, 115–124 )

    • Sorry to be so late in answering, Otto. In order to make medical appt. above, at Pa Hosp in Phila., I meant, you simply need to have access to a computer or smart phone,
      I said ” But what if you’re one of three Americans who don’t own a cell phone or else belong to the 47% of those over 65 who don’t use the Internet and try to get an appointment?” That’s all I meant. You CAN”T get an appt., therefore if you belong to one of these subsets.
      Your third paragraph is somewhat argumentative, and therefore I will not enter the argument. Read it any way you wish.

      But I do like your last paragraph referring to As you Like IT Act 4.

      All the best,

      Martin

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